Get the straight facts on erectile dysfunction medications

Dr. David Samadi MD New York Daily News

via NY Daily News

Approximately 30 million men have a problem getting or maintaining an erection, according to the Urology Care Foundation. This inability to perform sexually is known as erectile dysfunction (ED) and can be a cause of turmoil and stress for men.

When ED strikes, many men will have a discussion with their doctor about using an oral ED medication. Treating ED with an oral medication did not arrive on the scene until 1983, when a physiologist was able to demonstrate the effect of phentoalmine on inducing an erection.

This laid the path for the later development of oral agents, with the first being Viagra, introduced in 1989.

Since then, Viagra has been joined by other ED medications Cialis and Levitra. How does a man decide which one is right for him? What are their similarities or do they have vast differences?


How do ED drugs work?

Viagra, Cialis, and Levitra are all used to treat ED. They are also known by their generic names of sildenafil (Viagra), tadalafil (Cialis), and vardenafil (Levitra).

Each of them work in a similar manner and are in a class of drugs called PDE-5 inhibitors. They work by blocking an enzyme called phosphodiesterase type 5 while boosting a chemical in your body called nitric oxide.

This helps the muscles in the penis to relax, allowing blood flow into the penis to help achieve and maintain an erection when aroused.

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Each of the medications do not cause an instant erection — they take about 30 minutes to become effective. These medications can make an erection physically possible for men who may not be able to have one otherwise, but they are not aphrodisiacs. In other words, they don’t stimulate a man’s sex drive or make him become aroused. That still has to be done the old fashioned way — a man must be sexually aroused for the drugs to work.

Men who are depressed, have low testosterone levels or have little interest in sex may have no reaction whatsoever from ED medications. Also, ED drugs do not work for every man, as about a third of men who try an ED do not have a satisfactory result.

Who should not use ED medications?

Certain men are not considered good candidates for using ED medications. A man who is taking any form of nitrates for chest pain, or alpha-blockers for high blood pressure, should not be prescribed an ED drug as it can cause a sudden and dangerous drop in blood pressure.

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Men who take nitroglycerin or a similar medication for chest pain should also not use ED drugs as it can cause low blood pressure.

Each of the ED medications can also cause a small risk of priapism, which is a prolonged, painful erection lasting four hours or more in which blood fails to drain from the penis and does require a trip to the emergency room.

A minority of men will have side effects from an ED medication including headaches, blurry vision, a feeling of warmth, back pain, muscle aches, nasal congestion and an upset stomach or heartburn.

What differences are there between the drugs?

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Since Viagra, Cialis, and Levitra all work similarly, there are subtle differences between them.

Levitra works a little longer than Viagra but they both take effect in about 30 minutes. Levitra’s effect should last for about five hours while Viagra lasts about four hours.

Cialis comes in two forms — one for daily use and a higher dose that can work for up to 36 hours, meaning it stays in your system longer.

Cialis and Viagra can be taken with or without food while Levitra is to be taken on an empty stomach.

Cialis can also interact with alcohol by causing low blood pressure when standing up from a sitting or lying position resulting in dizziness or a headache.

Viagra and Levitra do not seem to cause low blood pressure when taken with alcohol, but alcohol may inhibit the ability to get an erection.

Similarities between the drugs

Viagra, Cialis, and Levitra have many more similarities between them than differences. They are all used only to treat ED, they all come in an oral tablet, each are to be taken 30-60 minutes before sex or once daily, they should be stored at room temperature and most pharmacies carry them, with each drug costing about the same.

Most health insurance companies do not cover the cost unless you have certain medical conditions.

When used correctly, each of these ED drugs have helped men with ED and with good results. If one drug doesn’t work, then another one can be tried. Sometimes it also takes some patience to get the dosage right for each individual man.

The decision to use an ED medication should be thoroughly discussed with your physician. They can guide a man on which ED drug is the most suited for him to achieve the results he is wanting with the least amount of side effects.

Men should always remember to tell their doctor of any over-the-counter or prescription medications or herbal or dietary supplements they are using. All health conditions should also be thoroughly discussed.

Dr. Samadi is a board-certified urologic oncologist trained in open and traditional and laparoscopic surgery and is an expert in robotic prostate surgery. He is chairman of urology, chief of robotic surgery at Lenox Hill Hospital. He is a medical correspondent for the Fox News Channel’s Medical A-Team

Get the straight facts on erectile dysfunction medications
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Dr. David Samadi, MD.

Dr. David Samadi is a Urologic Oncology Expert and Robotic Surgeon who was included in the prestigious Castle Connoly's America’s Top Doctors and New York Magazine’s Best Doctor’s List.

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Dr. David Samadi, MD.

Dr. David Samadi is a Urologic Oncology Expert and Robotic Surgeon who was included in the prestigious Castle Connoly's America’s Top Doctors and New York Magazine’s Best Doctor’s List.